Lesson 1:
Introduction to Nursing Rules and
Ethics
As members of the healthcare industry,
Certified Nurse Aides will be expected to
uphold the standard code of ethics observed
by all nurses nationwide. The American Nurses
Association (ANA) is the premier organization
representing the interests of more than 4
million of the nation’s registered nurses. ANA
advances the nursing profession by fostering
high standards of nursing practice that are
recognized by majority of the nation’s
healthcare professionals.
The Nursing Code of Ethics:
• Respect for Human Dignity &
Relationships with Patients
• The Privacy of Patients’ Interests
• The Protection of the Rights of Privacy
and Confidentiality
• A Nurse’s Authority, Accountability, and
Responsibility to their Patients
• The Preservation of Integrity and
Wholeness of Character
• The Responsibility for the Ethical
Standard of the Healthcare Environment
• The Continued Personal Contributions
through Nursing & Health Policy
Development
• The Obligation to Advance Health and
Human Rights
• Integrating Social Justice in Nursing and
Health Policy
Nursing Assistant Responsibilities:
As a Certified Nurse Aide, you are under the
continuous supervision of a registered nurse.
This supervision allows you to perform your
own tasks, as well as to observe your
supervisor perform tasks suitable to their
training and certification.
The healthcare industry is set up with the
awareness that each healthcare member has a
distinct role in regards to patient care. A
doctor will diagnosis and create surgical plans,
a surgeon will operate, a pharmacist will
distribute medications, and a nurse will
administer vaccinations, among many other
things.
As a CNA you will have many tasks suitable for
your training, some will include taking a
patients vitals, dressing a patient, transferring
a patient to other departments, and much
more. You are not, however, authorized to
remove tubes from a patient, offer diagnosis, or
perform procedures that require sterile
techniques. It is important that you are familiar
with your limitations, but also very aware of
the tasks going on around you. The healthcare
industry is one of the fastest growing
industries in the nation; job advancement is
highly encouraged and often readily available
to hardworking and knowledgable CNAs.
Check your state’s Department of Health to
find out limitations.
Legal Aspects of Nursing
Abuse & Neglect
As the population ages, more healthcare
professionals are administering to elderly
patients. The National Center on Elder Abuse,
directed by the U.S Department of Aging, is
committed to helping facilities be fully
prepared to ensure that elders live with dignity
and without abuse. Abuse is not limited to the
home life of a patient, but can also be
determined from their healthcare experience.
Examples of abuse within the healthcare
environment could include: unclean or unsafe
living conditions, significant weight loss by a
patient, missing equipment that would ensure a
steady recovery, medication being poorly
administered, and any form of bed sores that
would confirm lack of care. If you do notice any
of these signs notify your supervising nurse
immediately. If these things go unlooked you
could be held legally responsible.
Privacy Act
The Privacy Act (1974) regulates the collection,
use, maintenance, and distribution of
personally identifiable information about
individuals that is kept in the record systems of
federal agencies. This act has been described
as a consumer protection act, prohibiting
healthcare professionals from leaking patient
information.
The Privacy Act can be further expanded to
include social networking. Without a patient’s
consent through the use of a HIPAA-compliant
consent form it is illegal to share personal
healthcare information.
It is important to be aware of the laws
surrounding your profession, as they are
extensive and ever-changing to adapt to the
growth and scientific developments of the
healthcare industry.
Malpractice
Malpractice is negligence, misconduct, or a
breach of duty by a professional that results in
injury/damage to a patient.
You can avoid the risk of being accused of
malpractice by being in continuous
communication with your patient, documenting
everything, using all authorized equipment
correctly, and following the standards of care
listed by your care facility.
Reporting & Recording
Reporting is the oral account of care and
observations. You report care and observations
to the nurse when:
• There is any change in condition
• You leave for breaks or meals, and before
the end of your shift
Tips for reporting:
• Give person's full name, room number, and
bed number
• What you observed and time of
observation
Tips for recording:
• Always use ink
• Always use your name and title
• Use a patient’s full name and room
number
• Don't skip lines
• Always make sure you’re recording the
right patient
Recording Time:
You will most always record time in 24 hour
clock/military time. To add what minute it is
put the minutes where the 0's are: For example
4:32 p.m. would be 1632 in 24 hour
clock/military time.
Nutrition and Fluids
Protein: It is the most important nutrient. It is
needed for tissue growth and repair. Sources
include: meat, fish, poultry, eggs, milk, and milk
products, cereals, beans, peas, and nuts.
Carbohydrates: It provides energy and fiber for
bowel elimination.
Fats: It provides energy and they add flavor to
food and help the body use certain vitamins.
Vitamins: These are needed for certain body
functions. They don't provide calories. The body
stores vitamins A, D, E & K.
Minerals: These are used for body processes
needed for bone and teeth formation, nerve
and muscle function, fluid balance, and other
processes.
Water: It is essential for the body to operate,
up to 60 percent of the human adult body is
water.
Diets
Doctors may order special diets for patients.
• Sodium Controlled - The American Heart
Association recommends no more than
2300 mg a day, a sodium controlled diet
measures sodium intake per patients
needs.
• Diabetes Meal Plan - The American
Diabetes Association recommends
measured diets that help to balance
blood sugar.
• Dysphaga Diet - The doctor, speech
therapist, or occupational therapist
chooses the right food thickness per
patient. This is for someone who has
difficulty swallowing.
Fluids
Adults need 1500ml of water daily to survive.
About 2000 to 2500ml of fluid is needed for
normal fluid balance.
• Encourage Fluids - Increase amount of
fluids.
• Restrict Fluids - Fluids are limited to
certain amount set by doctor.
• Nothing by Mouth (NPO) - Person cannot
eat or drink by mouth.
• Thickened Liquids - All fluids are
thickened, including water.
Professional Care
• Always address patient by their last
name, unless instructed.
• Avoid the use pet names such as honey,
sweetie, or grandma.
• Set a professional standard of respect.